Investigating health effects of indoor chemicals from common household products in older people

Transcription

1 Investigating health effects of indoor chemicals from common household products in older people Alexandra Farrow, Anita Atwal, Gera Troisi, Alan Reynolds Brunel University School of Health Sciences & Social Care & Experimental Techniques Centre Brunel

2 Outline Personal Care Products with volatile organic compound (VOC) emissions Evidence of adverse health outcomes from VOCs Adverse health outcomes in older people Existing research on indoor air and health of vulnerable populations Need for future research and appropriate methodology

3 Personal Care Products (PCP)..chemicals marketed for direct consumer use PCP chemicals are directed at altering odour, appearance, touch, or taste. Most are used as active ingredients or preservatives in cosmetics, toiletries, or fragrances. Many PCP substances are used in very large quantities frequently more than recommended.

4 Personal care products produced in Product category Germany in 1993 Tons produced Bath additives 162,300 Shampoos, hair tonic 103,900 Skin care products 75,500 Hair sprays, setting lotions, hair dyes 71,000 Oral hygiene products 69,300 Soaps 63,600 Sun screens 7,900 Perfumes, aftershaves 6,600 Total 559,100 Ref: daughton/abstract.html

5 Evidence for associations between exposure to VOCs and adverse health: Toxicology Occupational studies Non-occupational and community studies

6 Some toxicology research I Product Chemicals Authors Year Effects Soaps, deodorants, cosmetics Air fresheners: fragrance products Solvents: toluene/styrene AETT Spencer et al 1979 Hyperirritability, limb weakness Vehicle for active component Styrene metabolite PGA Anderson & Anderson Ladefog et al 1997, vision, kidney, peripheral nerves, ototoxicity Antiseptics eg Triclosan Irritants, neurotoxicity isopropanol component Sethre et al 2000 Human neurobehavioural effects

7 Some toxicology research II Product Chemicals Authors Year Effects Reaction mixture Fragrance products Chemical mixtures Limonene/ ozone Coumarin conc.: to 0.61%. Trichloroethylene, heptachlor, Clausen et al 2001 Sensory airway irritation Wisneski 2001 animal carcinogen Moser et al 2003 Irritants, neurotoxic effects

8 Some occupational studies I Populations Exposure/industry Author Year Effect/symptoms Lab personnel organic solvents Campagna et al 1995 Neurophysiologic alteration Indoor cleaners sprayers Nielsen & Bach 1999 eye and respiratory Gen pop of 12 EU countries farmers & cleaners Kogevinas et al 1999 bronchial hyperresponsiveness Indoor cleaners sprays Zock et al 2001 asthma

9 Some occupational studies II Populations Exposure/industry Author Year Effect/symptoms Exposed workers Toluene Cavalleri et al 2000 Dose-related colour vision impairment Exposed painters Pop. based new asthma (ca-co study) Solvents including toluene Finnish working population Dick et al Jaakola et al Impaired colour vision, cognitive defects, tremor Women: increased asthma in waiters, cleaners Maternal occupational exposure Solvents Laslo Baker et al, Child neurodevelopment

10 Non-occupational occupational and community studies I Populations Exposure/products Authors Year Effect/symptoms Louisiana homes Formaldehyde Lemus et al 1998 Upper respiratory irritant School pops (children with no atopy) Formaldehyde Smedje, Norback 2001 Asthma diagnosis more common at higher concentrtion Children at home (ca-co study) Russian schoolchildren Formaldehyde Rumchev 2002 Asthma risk et al significantly raised Housing materials w. chemical emissions Jaakkol a et al 2004 Allergy, wheezing, asthma

11 Non-occupational occupational and community studies II ALSPAC The Avon Longitudinal Study of Parents and Children (Children of the 90s) is a unique ongoing research project based in the University of Bristol. It enrolled 14,000 mothers during pregnancy in and has followed the children and parents in minute detail ever since. Farrow A, Taylor H, Northstone K, Golding J, ALSPAC Study Team. Symptoms of Mothers and Infants Related to Total Volatile Organic Compounds in Household Products. Archives of Environmental Health Oct 22nd

12 Fragrances in air fresheners Artificial fragrances are found in air fresheners and in general aerosol and household spray products. > 4,000 chemicals in fragrance products No human toxicity testing on most Low - moderate exposure to artificial fragrances can significantly worsen asthma in a large % of asthmatics Asthmatic development related to indiscriminate use of household products

13 Recent research on indoor air and health of vulnerable populations Rumchev et al, (2004) : Association of domestic exposures to VOCs and asthma in young children Childhood asthma cases were exposed to significantly higher VOC levels than controls Each 10 unit increase in toluene and benzene concentration (microg/m3) increased risk of asthma by ~ 2 and 3 times, respec. Total VOC measure may underestimate the risks associated with individual compounds Uter W, Schnuch A (2004) Fragrance allergy increases with age. Br J Dermatol. 150(6):

14 Selected morbidity and mortality in the elderly Respiratory (eg.copd, asthma) Neurotoxic or cognitive effects Motor dysfunction Loss of visual acuity Falls

15 Asthma Asthma mortality rate (per million) in UK in 1999: 0-14 yrs yrs yrs 24.0 >65 yrs Dow et al, (2001): Asthma prevalence in 6000 >65 adults doctor diagnosed = 21% untreated asthma = 1.7% adults

16 Research questions for elderly populations How frequently are common household products used? Can a score be developed for total chemical burden for frequency of use of household products? Can improved monitoring tools be developed for measuring individual exposure to VOCs? Is there an association between VOC levels and use of household products such as air fresheners? Are there associations between higher levels and adverse health outcomes including functional disability

17 Approaches Using the MOSAIC UK database, postcodes can be identified with high and low household product purchase Within these high and low product postcodes, sample populations could be selected from GP lists VOC exposure profiles for the elderly could be determined by monitoring, interview and questionnaires Health outcomes could be measured eg. lung function tests, cognitive function, visual acuity

18 Future research to evaluate chemosensory irritation from VOCs should be able to: distinguish between the annoyance factor from odour sensation and that elicited by true sensory irritation evaluate exposure-related factors that affect odour or irritancy responses separate true adverse health effects from those mediated via psychosocial factors

19 EU Initiative : Integrated Project OPErational methodologies and tools for Health Risk Assessment [OPEHRA] as part of the EC Environment and Health Initiative Need for adapting current risk assessment methodologies for vulnerable individuals Biomarkers for assessing health impact and the development of better monitoring and early warning tools

20 Biomonitoring VOCs in elderly groups High-throughput Exposure Monitoring Identify individual chemical(s) for analysis Identify suitable biological samples (plasma, urine, breath) Where possible analyse chemical(s) using high-throughput analysis (e.g. ELISA) Commercially available in situ monitoring kits available. Need more alternatives to existing traditionally-used expensive, difficult, costly & time-consuming chromatographic techniques (e.g. GC-MS)

21 Biomonitoring VOCs in elderly groups High-throughput Health Effects Monitoring Identify biomarkers specific to chemical of interest Individual chemical (e.g. formaldehyde, benzene) or mixture (e.g. VOCs) Where none available, use suite of complementary biomarkers Most biomarkers are diagnostic of multiple health outcomes Select combination of biomarkers able to corroborate each other Analysis of Biomonitoring Data Use epidemiological approaches to look for BM associations with exposure independently of confounding factors

22 Source:Allergy UK 2004

23 Forecast Global Sales of Household Care Products: % Constant Value Growth SOURCE: EUROMONITOR ARCHIVE: Less is more in household care

24 Forecast Sales of Household Care Products by Sector: % Constant Value Growth SOURCE: EUROMONITOR ARCHIVE: Less is more in household care